Low breastfeeding rates and "aggressive" baby formula marketing have raised the ire of delegates at the World Health Organisation's Western Pacific meeting on Tuesday.
Ramping up efforts to combat advertising for breast milk substitutes is likely to be a core component a new WHO regional action plan being developed to strengthen protections for children from the harmful impact of food marketing.
"The baby formula business is booming," WHO's regional director, Dr Shin Young-soo, said, and that "is undermining breastfeeding".
The Asia Pacific region accounts for more than $US20 billion of the $US36 billion in global growth of infant formula sales since 2003, according to WHO.
WHO director of nutrition for health and development Dr Francesco Branca said the region fell well below the 2025 target of increasing to at least 50 per cent the rate of exclusive breastfeeding in the first six months.
Cambodia is the only country in the region where more than half of all new mothers breastfeed up to six months.
"Aggressive marketing of infant formula plays a role in low breastfeeding rates," Dr Branca said.
Just over 15 per cent of Australian babies are exclusively breastfed up to six months, the 2010 Australian National Infant feeding Survey found, and 39 per cent are exclusively breastfed up to four months of age.
Tensions between the pressures to breastfeed and the need for greater acceptance of breastfeeding have become lightning rods for heated discussion in Australia.
Some women have been criticised for breastfeeding in public, others have felt like failures if they turn to formula after struggling to breastfeed, or judged for choosing not to do so.
"That is exactly the challenge. This is not the responsibility of the mums only, this is the responsibility of the whole family and the whole society," Dr Branca said.
"If we don't provide the right support for breastfeeding mothers, giving them enough time off work or by allowing them to breastfeed [at work]; if we don't have family support where breastfeeding is seen as valuable and that interaction between the mother and child is protected, then I can understand why the convenience element [of formula] prevails and that's where the marketing comes in."
Baby formula under six months was justified in a very small number of cases, in which the mother has a contraindication, Dr Branca said.
"In reality the social circumstances make it difficult and all the social circumstances can be addressed.
"We are going to have healthier children, children with a higher intellectual quotient and children who are less prone to the risk of non-communicable diseases."
The Australian Medical Association released a new position statement in July acknowledging breastfeeding was the optimal method for feeding infants, and should be promoted. The AMA called for targeted support to increase rates.
But the statement also recognised women who could not breastfeed or choose to use formula also needed to be supported.
"The difficulties with breastfeeding are a source of great disquiet for a lot of women and for some it seriously contributes to postnatal depression and postnatal anxiety," AMA president Michael Gannon said.
The obstetrician and gynaecologist said he had looked after hundreds of women who were on a three-hourly cycle of feeding, settling and expressing that left them no time to rest, enjoy their baby and bond or attend to other children.
"We need to recognise there will be a minority of women who can't, and a not-so-small minority who find breastfeeding so disruptive to the rest of their lives," Dr Gannon said.
"We should support their right to choice, as long as they are appropriately informed and given good quality education as to the benefits of breastfeeding, that's their choice."
Fourteen infant formula suppliers are signatories to the National Marketing in Australia of Infant Formula (MAIF) Agreement, a code of conduct that stipulates manufacturers and importers "should not advertise or in any other way promote infant formulas to the general public".
Australia's breastfeeding guidelines are in line with WHO recommendations that infants up to six months should be exclusively breastfed.
A spokeswoman said the Department of Health was currently developing an enduring Australian National Breastfeeding Strategy to replace its 2010-15 recommendations, and stakeholders said the strategy should strengthen the implementation of the WHO code.